Hepatitis C Antibody Positive (HCV Ab+)/Nucleic Acid Test Negative (NAT -) Deceased Donor Kidney Transplantation into Hepatitis C Negative (HCV -) Recipients: Is It Safe?
Ohio State University, Columbus, OH
Meeting: 2019 American Transplant Congress
Abstract number: D233
Keywords: Donors, marginal, Hepatitis C, Infection, Kidney transplantation
Session Information
Session Name: Poster Session D: Non-Organ Specific: Viral Hepatitis
Session Type: Poster Session
Date: Tuesday, June 4, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Kidneys procured from HCV Ab+/NAT – are not routinely used due to concern for HCV transmission into recipients. However, there has been no report to date confirming such concern. The American Society of Transplantation Consensus Conference on use of hepatitis C viremic donors in organ transplantation concluded that HCV ab+/NAT- status alone does not increase risk of transmission. With this background and in light of the growing organ shortage and the development of highly effective direct antiviral drugs, our center decided to proceed with offering HCV ab+/NAT- to HCV negative patients.
*Methods: We report on our single-center experience in transplanting HCV Ab+/NAT- deceased donor kidneys into HCV- recipients since November of 2017. Donor and recipient characteristics were collected. Recipients received routine post-transplant care along with serial HCV antibody and NAT testing every three months up to one year. Our primary outcome was conversion to HCV Ab+ or HCV NAT+ status. Our secondary outcome was graft function.
*Results: Between Nov-2017 and Sept-2018, we performed a total of 15 deceased donor kidney transplants from HCV Ab+/NAT – making up 9% of our deceased donor kidney transplant volume. Our mean follow-up was 6±3 months. Mean recipient age was 57 ± 9 years with 79% being males. Mean donor age was 42±9 years with 57% being males. Mean donor KDPI was 64% ±14%. 71% of donors met Public Health Service increased risk criteria. All patients received induction with thymoglobulin and maintenance therapy with tacrolimus and mycophenolic acid. None of the recipients became HCV NAT +.Two recipients seroconverted to HCV Ab+ status , but remained HCV NAT -. There were no cases of delayed graft function with all grafts functioning within the follow up period.
*Conclusions: Our results demonstrate that deceased donor kidney transplant from HCV Ab+/NAT – is associated with very low, if any, risk of HCV transmission. We propose that HCV Ab+/NAT – deceased donor kidney transplantation into HCV- recipients is safe and can be routinely practiced provided informed patient consent is obtained and appropriate follow up protocol is established.
To cite this abstract in AMA style:
Taehwan Y, Rajab A, Bumgardner G, Pesavento t, Daloul R, Michaels A, Washburn K, El-Hinnawi A. Hepatitis C Antibody Positive (HCV Ab+)/Nucleic Acid Test Negative (NAT -) Deceased Donor Kidney Transplantation into Hepatitis C Negative (HCV -) Recipients: Is It Safe? [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/hepatitis-c-antibody-positive-hcv-ab-nucleic-acid-test-negative-nat-deceased-donor-kidney-transplantation-into-hepatitis-c-negative-hcv-recipients-is-it-safe/. Accessed November 22, 2024.« Back to 2019 American Transplant Congress